Multiple hyperdontia: Report of an unusual case

Supernumerary teeth are an infrequent developmental anomaly that can appear in any area of the dental arch and can affect any dental organ. Multiple supernumerary teeth, or hyperdontia, is rare in people with no other associated diseases or syndromes. Conditions commonly associated with hyperdontia include cleft lip and palate, trichorhinophalangeal syndrome, cleidocranial dysplasia, and Gardner's syndrome. A black girl, aged 11 years 8 months, came for consultation; radiographs showed 81 teeth: 18 deciduous, 32 permanent, and 31 supernumerary. The main concern initially was to determine whether she was syndromic, and she was referred to a geneticist. G banding analysis showed pericentric inversion of chromosome 9; the chromosome formula was 46, XX, inv (9) (p13q21). Orthodontic treatment for this patient will be a clinical challenge because of the great number of teeth to be extracted and the alterations in the shapes of the teeth. Treatment goals should be established by a multidisciplinary team, where oral surgeon, orthodontist, periodontist, and prosthodontist come together to solve a medical and dental puzzle, eliminating the pieces that do not fit and searching for new ones to obtain an occlusion that will give the patient physiologic conditions of normality and esthetic satisfaction.     

Orofacial granulomatosis associated with hypersensitivity to dental amalgam

Orofacial granulomatosis is a clinicopathologic entity characterized by chronic swelling of the lip and possible soft tissues in the orofacial region owing to granulomatous inflammation of unknown cause. We present 3 cases of orofacial granulomatosis associated with allergic contact dermatitis to dental materials. Previous treatment with corticosteroids did not have any therapeutic effect. Patch testing revealed a positive reaction to several allergens, including dental amalgam and mercury in 2 cases. A lymphocyte transformation test modified for metals was used to evaluate lymphocyte reactivity. After the removal of the suspected allergens, all patients experienced recovery within 1 month, with the exception of the lip swelling, which gradually subsided over several months.     

Histologic evaluation of the buccal and lingual bone plates in anterior dog teeth: possible influence on implant dentistry

Background: Recent studies in animals have shown pronounced resorption of buccal bone plate after immediate implantation. The sectioning of experimental material for histologic evaluation of the bone plates could provide valuable information about the possible effect of bone exposure in periodontal and implant surgeries. Methods: Twenty‐four incisors were collected from dogs. After decalcification, the blocks were immersed in paraffin and bucco‐lingual histologic sections were examined under light microscope. Some sections were reserved for immunohistochemical analysis. Results: The bone density, the width of the bone plates, and the percentage of vessels presented in the periodontal ligament and periosteum were analyzed in the buccal and lingual bone plates, which were divided corono‐apically into thirds. The buccal bone plates showed statistically higher bone density compared to the lingual bone plates in the coronal thirds. The width of both bone plates increased from the coronal to the apical third, but all the buccal thirds were significantly thinner compared to the lingual thirds. No statistically significant differences were found between the bone plates for the percentage of area occupied by the blood vessels in the periodontal ligament or periosteum. Conclusion: It is reasonable to conclude that the higher bone density, represented by the lower number of marrow spaces, in association with the thinner aspect of the buccal bone plates made them more fragile to absorb compared to the lingual bone plates, especially during mucoperiosteal procedures.     

An atypical lingual lesion resulting from the unhealthy habit of sucking the lower lip: clinical case study

Unhealthy oral habits may be involved in the etiology of a malocclusion, since they may affect development of the orofacial region. There is little information on the habit of sucking the lower lip, to which practitioners attribute less clinical consequences. However, lower lip sucking is a harmful habit which appears frequently in children, especially during situations requiring increased attention and mental concentration. In patients presenting lower lip sucking, strong contractions of the lower lip's orbicular's muscle and the mentalis muscle, associated with hypertonicity of the upper lip caused by sucking, has to be balanced by lingual thrusting during the act of deglutition. A case is presented in which failure to identify the habit of lower lip sucking led to an atypical lesion on the tongue, caused by the tongue's impaction against the orthodontic appliance prescribed to correct a malocclusion. The recognition and elimination of an unhealthy habit is of great importance in diagnosis and the establishment of a treatment plan, so that undesirable complications can be avoided.     

Panoramic radiograph as a method for detecting calcified atheroma plaques. Review of literature

Cerebrovascular accident (CVA) is the third cause of death in industrialized countries, following cardiovascular disease and cancer. It is therefore a significant public health issue, not only due to its high incidence, but also to the high costs involved in the physical and psychological rehabilitation of these patients. Dental Practitioners, as health care providers, ought to play their part in this issue and contribute, within their means, to the early detection of patients at risk of having a CVA. Since the eighties, different authors have described the possibility of detecting calcified atheroma plaques located at carotid artery bifurcation through panoramic radiograph. In this way, the Dental Practitioner s possibilities in this field have been extended. However, this new use of panoramic radiograph must overcome certain obstacles before it is implemented as a new screening method for patients at risk of having a CVA. Amongst these, we would have, on the one hand, the assessment of the real clinical significance, as regards prognosis, of atheroma plaque calcification as well as its usefulness as a factor for predicting the appearance of CVA symptoms and, on the other hand, the possibility of making a correct differential diagnosis regarding other calcified structures that may appear on panoramic radiograph.     

Unusual presentation of active implant periapical lesions: a report of two cases

Active implant periapical lesion (IPL) is a rare lesion which has been reported as one of the causes of dental implant failures. Usually, an affected implant shows radiolucency in the apical area, while remaining clinically stable. IPL is often accompanied by symptoms of pain, swelling, tenderness, and fistulation. In this paper, we describe two cases of IPL with very unusual findings which led to implant failure. A large IPL associated with an inflammatory cyst in the anterior maxilla, and a mandibular IPL resulting in an extra-oral fistula are presented. The etiology and treatment approaches for IPL are discussed.     

Fracture process characterization of fiber-reinforced dental composites evaluated by optical coherence tomography, SEM and optical microscopy

This study used optical coherence tomography (OCT) compared to scanning electron microscopy (SEM) and optical microscopy (OM) to evaluate qualitatively crack propagation and final fracture in restorative composite materials - Filtek Z250 and Filtek Z350 (3M ESPE) - with fiber reinforcement after cyclic loading. Samples were made using a split mold. Initially, 3-point bending tests were performed to determine the maximum force and tension at the fracture moment using samples without fiber reinforcement. Then, mechanical cycling tests were performed using samples with glass fiber embedded internally. The failures were analyzed using the 3 methods described before. OCT permitted good characterization of internal crack propagation of the dental composites, which, however, could not be visualized by either SEM or OM. OCT was proven to be laboratory research tool that is easy to use, does not require any specific preparation of the samples, and is less expensive than SEM.